Sizakele Mathe, left, a treatment adherence counselor, with Silendile Mdunge in the township of Ntuzuma, north of Durban, South Africa, Nov. 14, 2021:
This combination of high tech and grassroots represents one of the front lines in the world’s battle against the evolving coronavirus. On Friday, the research network in South Africa reported to a world waiting anxiously for new information that the new variant appeared to spread twice as quickly as delta, which had been considered the most contagious version of the virus.
“We have reasons to believe that some of the variants that are emerging in South Africa could potentially be associated directly with HIV,” said Tulio de Oliveira, the principal investigator of the national genetic monitoring network. An HIV infection makes a person about 1.7 times more likely to die of COVID-19 — an elevated risk, but one that pales in comparison with the risk for people with diabetes, who are 30 times more likely to die.
“We don’t have a lot of people like her,” Abdool Karim said of the woman who took 216 days to clear the coronavirus from her system. “But it doesn’t take a lot of people; it just takes one or two.”The origin of this variant is still unknown. People with HIV are not the only ones whose systems can inadvertently give the coronavirus the chance to mutate: It can happen in anyone who is immunosuppressed, such as transplant patients and those undergoing cancer treatments.
That is where the efforts of community health workers such as Mathe come in. On a typical workday, she walks dirt paths past leaking standpipes and front-step hair salons, armed with an ancient cellphone and a mental roster of who has turned up at the clinic lately, who is looking unwell and who needs a visit. Mathe, who herself has been on HIV treatment for 13 years, is paid $150 a month.
Of the 8 million South Africans with HIV, 5.2 million are on treatment — but just two-thirds of that group are successfully suppressing the virus with medication. The problem extends beyond South Africa’s borders: 25 million people live with the virus across sub-Saharan Africa, of whom 17 million are virally suppressed with treatment.
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